Pincus T, Mitchell J M, Burkhauser R V
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232.
J Clin Epidemiol. 1989;42(5):449-57. doi: 10.1016/0895-4356(89)90135-2.
Substantial earnings losses and work disability were seen in individuals less than age 65 with asymmetric oligoarthritis, a surrogate for osteoarthritis, almost as great as those seen with symmetric polyarthritis, a surrogate for rheumatoid arthritis. The proportions of individuals who were working was 66.7% for men and 35.5% for women with asymmetric oligoarthritis, compared to 56.1% and 31.0% of those with symmetric polyarthritis, and 89.4 and 61.6% of those with no arthritis. Rates of work disability in individuals with asymmetric oligoarthritis involving one knee or one hip were in the same range as those in individuals with symmetric polyarthritis involving two knees or two hips. The earnings of women and men with asymmetric oligoarthritis were only 30 and 63% respectively of the earnings of persons with no arthritis. However, less than one-third of these earnings losses were explained by the presence of arthritis, with further explanation from higher age, lower formal education levels, and comorbidity in individuals with asymmetric oligoarthritis. These results suggest that greater attention to demographic and comorbidity variables may be indicated in efforts to control economic losses associated with arthritis.
在65岁以下患有不对称性少关节炎(骨关节炎的一种替代指标)的个体中,出现了大量的收入损失和工作残疾情况,几乎与患有对称性多关节炎(类风湿性关节炎的一种替代指标)的个体一样严重。患有不对称性少关节炎的男性和女性的工作比例分别为66.7%和35.5%,而患有对称性多关节炎的男性和女性的工作比例分别为56.1%和31.0%,无关节炎个体的工作比例分别为89.4%和61.6%。涉及一个膝盖或一个髋关节的不对称性少关节炎个体的工作残疾率与涉及两个膝盖或两个髋关节的对称性多关节炎个体的工作残疾率处于同一范围。患有不对称性少关节炎的女性和男性的收入分别仅为无关节炎者收入的30%和63%。然而,这些收入损失中不到三分之一可由关节炎来解释,不对称性少关节炎个体的年龄较大、正规教育水平较低和存在合并症可进一步解释收入损失情况。这些结果表明,在努力控制与关节炎相关的经济损失时,可能需要更多地关注人口统计学和合并症变量。